The development of clinical guidelines in China: insights from a national survey
Por:
Song, Y, Li, J, Chen, YL, Guo, RX, Alonso-Coello, P, Zhang, Y
Publicada:
23 dic 2021
Resumen:
Background Previous research suggests that the quality of clinical guidelines (CGs) in China is suboptimal. However, little is known about the methodology that CGs follow. We conducted a national survey of methods used by Chinese CG developers for CG development, adaptation, and updating. Methods We used a previously piloted questionnaire based on methodologies of CG development, adaptation, and updating, which was distributed during September-November 2020 to 114 organizations identified from published Chinese CGs (searched 2017-2020), recommended by Chinese CG developers, and recommended by clinical discipline experts. Results We collected 48 completed questionnaires (42.1% response). Most organizations developed CGs based on scientific evidence (89.6%), existing CGs (75%), or expert experience and opinion (64.6%). Only a few organizations had a specific CG development division (6.3%), a CG monitoring plan (on clinicians 33.3%; on patients 18.8%), funding (33.3%), or a conflict-of-interest (COI) management policy (23.4%). Thirty (62.5%) organizations reported using a CG development methodology handbook, from international organizations (14/30, 46.7%), methodology or evaluation resources (3/30, 10.0%), expert experience and opinion (3/30, 10.0%), or in-house handbooks (3/30, 10.0%). One organization followed a published adaptation methodology. Thirty-eight organizations (88.4%) reported de novo CG development: 21 (55.3%) formed a CG working group, and 29 (76.3%) evaluated the quality of evidence (21 [72.4%] using a methodological tool). Nineteen organizations (52.8%) reported CG adaptation: three (31.6%) had an adaptation working group, and 12 (63.2%) evaluated the quality of source CGs (2 (16.7%) using the AGREE II instrument). Thirty-three organizations (68.8%) updated their CGs, seven (17.5%) using a formal updating process. Conclusions Our study describes how CGs are developed in a middle-income country like China. To ensure better healthcare, there is still an important need for improvement in the development, adaptation, and updating of CG in China.
Filiaciones:
Song, Y:
Zhengzhou Univ, Affiliated Hosp 1, Dept Gynaecol, Zhengzhou, Peoples R China
Biomed Res Inst Sant Pau IIB Sant Pau, Dept Clin Epidemiol & Publ Hlth, Iberoamerican Cochrane Ctr, Barcelona, Spain
Li, J:
Univ Autonoma Barcelona, Vall Hebron Univ Hosp Res Inst VHIR, Barcelona, Spain
Chen, YL:
Lanzhou Univ, Sch Basic Med Sci, Evidence Based Med Ctr, Lanzhou, Peoples R China
WHO Collaborating Ctr Guideline Implementat & Kno, Lanzhou, Peoples R China
Guo, RX:
Zhengzhou Univ, Affiliated Hosp 1, Dept Gynaecol, Zhengzhou, Peoples R China
Alonso-Coello, P:
Biomed Res Inst Sant Pau IIB Sant Pau, Dept Clin Epidemiol & Publ Hlth, Iberoamerican Cochrane Ctr, Barcelona, Spain
Ctr Invest Biomed Red Epidemiol & Salud Publ CIBE, Madrid, Spain
Zhang, Y:
McMaster Univ, Dept Hlth Res Methods Evidence & Impact HEI, Hamilton, ON, Canada
Green Published, gold
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